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While ROS can function as second messengers regulating cellular reproduction, growth, differentiation, and signaling when maintained at optimal concentrations and dynamic equilibrium, exceeding critical ROS thresholds induces oxidative stress, leading to DNA damage, protein denaturation, and lipid peroxidation—key factors in CHD development

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The HPA axis may also play a role in modulating the function of the HPG axis (Figure 2, middle panel)